内动脉狭窄的自然历史进展
Keerthi B Harish1, Giancarlo Speranza1, Caron B Rockman2
1New York University Grossman School of Medicine, New York, NY.
Journal of vascular surgery
|November 4, 2023
概括
内动脉狭窄症经常进展,特别是在糖尿病或血管炎的老年患者中. 建议对所有心血管疾病患者进行定期监测,以监测病情的进展和潜在的中风风险.
科学领域:
- 血管医学 血管医学
- 神经学 神经学
- 心脏病学 心脏病学
背景情况:
- 内动脉狭窄 (ICA) 是缺血性中风的重要危险因素.
- 了解ICA狭窄的自然史和进展对于患者管理至关重要.
- 以前的研究集中在干预后的结果上,但对保守管理患者的疾病进展知之甚少.
研究的目的:
- 为了研究内动脉 (ICA) 狭窄症进展的自然史.
- 确定与疾病进展和不良脑血管事件相关的风险因素.
- 评估中风或重血管化的发病率在中度至重度ICA狭窄症患者中.
主要方法:
- 在467名通过双重超声诊断的50%或更大的ICA狭窄症患者的回顾性队列研究 (2015-2022年).
- 从电子医疗记录中收集的数据,包括人口统计数据,临床病史和成像研究.
- 主要结局包括疾病进展 (狭窄类别的增加) 和中风或再血管化的发病率.
主要成果:
- 在研究的577个动脉中,21.3%的诊断时的非封闭性狭窄症进展.
- 高龄,糖尿病和血管炎史与狭窄症的进展有关.
- 抗血小板治疗趋向于降低进展率;5.6%的患者出现症状,包括缺血性中风.
结论:
- 很大一部分患有内动脉狭窄症的患者经历了疾病进展.
- 建议对所有心血管疾病患者进行长期监测.
- 应对患有糖尿病和血管炎史等危险因素的患者给予更多的关注.
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